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Can the Paleo Diet Help Diabetes?

The popular paleo diet may help people with diabetes better control their blood sugar.

An ancient way of eating may offer a brighter future for people with diabetes.

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After 55-year-old Steve Cooksey was diagnosed with type 2 diabetes in 2009, he knew he wanted to approach the disease differently from the way his two family members with diabetes had.

“I went home and realized that to eat their way required more and more insulin," he says. For some reason, "My blood sugar should have been going down, but it wasn’t.”

A few months after he was diagnosed, Cooksey abandoned the traditional diabetes diet in favor of the so-called paleo diet — a high-protein, low-carb food plan, likened to a “caveman diet,” that minimizes processed foods and emphasizes meats and vegetables. Within a month, Cooksey was able to stop taking all his medications, including those for diabetes, hypertension, and high cholesterol. He still checks his blood sugar regularly, and it’s always within normal ranges.

“I have normal blood sugars for normal people, not just normal blood sugars for a diabetic,” says Cooksey, whose website, Diabetes Warrior, explains the benefits of a paleo diet for diabetes.

The Potential Benefits of a Paleo Diet for Diabetes

Cooksey isn’t alone. In recent years, the popularity of the paleo diet has skyrocketed, with many of its proponents touting the approach as an effective way to improve health and lose weight.

A study suggests that people with type 2 diabetes who followed a "caveman diet" were able to improve their blood pressure, blood sugar levels, and cholesterol by significant amounts in just two weeks. Other study participants who followed a traditional diet recommended by the American Diabetes Association saw little to no improvement. The participants were given enough food to prevent them from losing weight, eliminating the possibility that the health improvements came simply from shedding pounds. (1)

Researchers aren’t sure why the paleo-diet followers had better health outcomes, but it’s possible that paleo-friendly foods might be better suited for a type 2 diabetes diet than other foods, says Lynda Frassetto, MD, a nephrologist and the lead researcher on the study. "We believe there are multiple factors involved, including more fiber leading to decreased uptake of sugar from the intestines, more micronutrients and antioxidants, and potentially a healthier impact on gut microflora," says Dr. Frassetto.

Dr. Frassetto adds that these findings suggest that not all carbs are created equal. Carbs from fruit and vegetables come packaged with antioxidants and micronutrients, making them better for you than carbs from the grain in wheat bread or cereals, she explains.

The same ECJN study mentioned above also found that eating lean cuts of meat and other foods found in the paleo diet, such as fruits, vegetables, and nuts, in the short-term improved insulin sensitivity and lipid levels in people with type 2 diabetes. (1)

People with type 2 diabetes who follow a paleo diet may find that it helps them better control their blood sugar, says Melissa Joy Dobbins, RD, CDE, a spokeswoman for the Academy of Nutrition and Dietetics. “You’re eating hardly anything that would raise your blood sugar,” Dobbins notes. “You’re really restricting carbs, and that can keep your blood sugar down.” (2)

The diet also encourages whole, unprocessed foods, which is a healthy approach, she adds. Plus, the “bulkiness” of the foods may mean that you will feel full on fewer calories, encouraging weight loss, which is also beneficial for type 2 diabetes. (2)

Why Some Experts Are Skeptical About Paleo

However, because this eating plan almost completely eliminates certain food groups, like grains, traditional wisdom would argue that it’s less healthy than a more well-rounded diet. “A lot of nutrition experts would say the paleo diet is not balanced,” Dobbins says.

Many versions of the paleo diet also encourage the consumption of red meats, full-fat dairy products, and saturated fats like butter, which can cause elevated cholesterol levels. (3) This can be an especially dangerous problem for people with diabetes because they are more likely to develop heart disease than people without diabetes. (4) “For people with diabetes, the primary goal is to control blood sugar, but the second goal is to reduce the risk of heart disease and its complications,” Dobbins says.

It should be noted that the paleo-diet participants in the EJCN study who were able to reduce their cholesterol levels did not eat red meats or saturated fats — their proteins came mainly from lean sources like fish and chicken, while the fats in the diet were heart-healthy, unsaturated types. (1)

For Cooksey’s paleo diet, he chooses whole foods over processed, packaged meals to help control his blood sugar levels. On a typical day, he might have a plate of eggs, greens, and bacon for breakfast; tilapia and spinach for lunch; and ribs with a low-carb barbecue sauce and mixed vegetables for dinner. Between meals, Cooksey munches on low-carb snacks like hard-boiled eggs, cheese, canned tuna, salmon, sardines, and certain vegetables, such as celery sticks, green peppers, broccoli, and cauliflower. He usually eats a full meal just once or twice a day.

Is the Paleo Diet Right for You?

Stories like Cooksey’s certainly are not unheard-of, Dobbins says, because the bodies of people with type 2 diabetes do still produce insulin on their own, and it could be enough to process the small amount of carbohydrates in a paleo diet. But it may not be a permanent solution.

“Whether it’s paleo or any restricted-carb diet, yes, people may go off insulin [shots],” Dobbins says. “But they may eventually need to go back on it, even if they don’t change their diet. It depends on how exhausted the pancreas is. It may run out, wear out.”

People with type 1 diabetes, who produce no insulin at all, would not be able to stop taking their diabetes medications by following a paleo diet, but the approach may help regulate their blood sugar levels. A small study found that people with type 1 who followed a low-carbohydrate diet for four years did not require as much insulin as they did before going on the diet, and their blood sugar levels were more even. (5)

People with diabetes who are interested in trying a paleo diet should consult their doctor or a registered dietitian before beginning the program. If you have kidney problems or are on certain medications, you may not be able to safely follow the plan. Because the paleo diet also involves large quantities of “bulky” food, those with intestinal conditions may not be able to tolerate it either. “It is a huge amount of food,” says Frassetto, who slowly introduced her study’s participants to the paleo style of eating over the course of a week. “If you have problems with your intestines moving, you will have a lot of problems with this diet,” she notes.

Those people who aren’t sure about following a paleo diet to manage their diabetes may see some benefit simply by incorporating a few of its principles into their current diet, like eating more fresh produce, and less pasta and bread.

“I think people in general eat too many carbs,” Dobbins says. “You could get rid of the excess. I’m a firm believer in getting a little more protein, making sure the fats are as heart-healthy as possible, and having fewer carbs. I think that is something people can live with and see good results with their blood sugar and their weight.”

Cooksey is convinced that the “paleo lifestyle” is the one for him. “I’m blessed to be a diabetic because it made me seek out a better way of living,” he says, “and I’ve found it.”

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